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Based on public Medicaid payment data.

Average Medicaid Prescription Medications Payments

Typical Medicaid Prescription Medications reimbursement across 5,304 cities

Avg. Medicaid Paid

$28.35

Price Range

$0.00 – $2,704

Total Claims

61.1M

Cities

5304

Typical Payment Range

Typical Medicaid Prescription Medications payments fall between $0.68 and $14.54 per claim (median: $2.87). The top 10% of payments exceed $78.92.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Pearl, MS $0.30 $0.00 – $0.43 64 2
Brentwood, CA $0.00 $0.00 – $0.00 64 1
Wesson, MS $0.00 $0.00 – $0.00 64 1
Ketchum, ID $2.76 $2.76 – $2.76 65 1
San Rafael, CA $6.87 $3.75 – $8.70 65 2
Blaine, MN $4.21 $0.15 – $6.83 65 3
Mchenry, IL $82.13 $82.13 – $82.13 65 1
West Melbourne, FL $6.96 $6.96 – $6.96 65 1
Huntingburg, IN $12.92 $0.00 – $19.53 65 2
Roscoe, IL $52.20 $2.45 – $81.33 65 2
Dahlonega, GA $0.59 $0.59 – $0.59 65 1
Nyc, NY $0.99 $0.27 – $1.94 65 2
Wallace, NC $48.02 $48.02 – $48.02 65 1
Riverbank, CA $205.38 $205.38 – $205.38 65 1
Magna, UT $19.66 $12.00 – $21.96 65 2
Jonesville, VA $1.34 $1.34 – $1.34 65 1
Tunica Resorts, MS $0.04 $0.04 – $0.04 65 1
Sidney, NE $3.26 $0.00 – $13.25 66 3
Arroyo, PR $0.00 $0.00 – $0.00 66 1
Uniontown, AL $0.00 $0.00 – $0.00 66 1
Norwood, OH $10.62 $0.96 – $15.84 67 3
Abbeville, SC $11.26 $0.00 – $55.73 67 3
Sapulpa, OK $3.73 $3.73 – $3.73 67 1
Villalba, PR $0.06 $0.06 – $0.06 67 1
Gueydan, LA $0.00 $0.00 – $0.00 67 1
Larchmont, NY $0.35 $0.35 – $0.35 67 1
Tiptonville, TN $1.00 $1.00 – $1.00 67 1
Tolleson, AZ $1.66 $1.66 – $1.66 67 1
Middlebrook, VA $0.40 $0.40 – $0.40 67 1
Atascadero, CA $63.40 $29.70 – $90.00 68 2
Saint Augustine, FL $0.05 $0.05 – $0.05 68 1
Chiloquin, OR $0.00 $0.00 – $0.00 68 1
Taylorsville, NC $8.90 $0.01 – $21.59 68 2
Providence, UT $1.30 $1.30 – $1.30 68 1
Estacada, OR $1,166 $1,166 – $1,166 68 1
Byram, MS $0.70 $0.30 – $0.82 68 2
Osceola, WI $0.03 $0.03 – $0.03 68 1
Lakewood, OH $176.26 $0.00 – $782.14 69 4
Pinole, CA $1,212 $57.48 – $1,480 69 2
Falkville, AL $0.45 $0.45 – $0.45 69 1
Waltham, MA $10.72 $10.72 – $10.72 69 1
Nottingham, MD $1.13 $1.12 – $1.14 69 2
Van Horn, TX $0.84 $0.84 – $0.84 69 1
Cataula, GA $0.84 $0.84 – $0.84 69 1
Worrester, MA $0.73 $0.73 – $0.73 69 1
Carthage, MO $0.26 $0.26 – $0.26 70 1
Channahon, IL $629.07 $598.31 – $675.20 70 2
Tuskegee, AL $0.42 $0.00 – $0.57 70 2
Waukegan, IL $12.21 $3.48 – $24.86 71 2
Gainesboro, TN $38.32 $38.32 – $38.32 71 1

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
J1100 Dexamethasone sodium phos $3.37 17,408,335 19,920
J1270 Injection, doxercalciferol $16.67 15,455,545 1,785
J0696 Ceftriaxone sodium injection $4.52 8,442,343 9,869
J1170 Hydromorphone injection $3.20 6,069,586 3,002
J1200 Diphenhydramine hcl injectio $3.10 5,922,771 3,790
J0690 Cefazolin sodium injection $5.07 4,950,109 2,942
J1050 Medroxyprogesterone acetate $38.04 2,722,661 5,740
J0131 Inj, acetaminophen (nos) $15.79 2,017,135 1,612
J1030 Methylprednisolone 40 mg inj $5.08 1,577,497 4,461
J0882 Darbepoetin alfa, esrd use $63.10 1,115,197 646
J1040 Methylprednisolone 80 mg inj $6.39 1,102,119 2,895
J0585 Injection,onabotulinumtoxina $534.00 949,108 1,450
J0702 Betamethasone acet&sod phosp $9.01 907,372 2,580
J0780 Prochlorperazine injection $4.11 869,130 1,089
J0178 Aflibercept injection $802.42 747,781 1,182
J0171 Adrenalin epinephrine inject $5.61 533,091 956
J0897 Denosumab injection $708.53 175,698 394
J1071 Inj testosterone cypionate $3.01 121,666 206
J0636 Inj calcitriol per 0.1 mcg $2.19 94,974 28
J0885 Epoetin alfa, non-esrd $82.64 88,458 179
J1020 Methylprednisolone 20 mg inj $3.48 88,065 344
J0881 Darbepoetin alfa, non-esrd $149.52 63,199 108
J0878 Daptomycin injection $167.80 55,762 36
J1245 Dipyridamole injection $5.21 54,912 138
J0592 Buprenorphine hydrochloride $15.56 48,440 32
J0153 Adenosine inj 1mg $18.75 46,321 143
J0670 Inj mepivacaine hcl/10 ml $0.91 37,668 90
J0129 Abatacept injection $1,614 34,397 89
J0735 Clonidine hydrochloride $6.85 32,191 92
J0610 Calcium glucon (fresenius) $9.34 31,253 88
J0135 Adalimumab injection $738.85 28,382 35
J1094 Inj dexamethasone acetate $2.39 27,586 144
J0717 Certolizumab pegol inj 1mg $2,072 22,279 41
J0697 Sterile cefuroxime injection $0.94 18,132 47
J0256 Alpha 1 proteinase inhibitor $2,389 16,156 1
J1250 Inj dobutamine hcl/250 mg $6.92 14,579 60
J0588 Incobotulinumtoxin a $295.98 10,950 18
J1325 Epoprostenol injection $636.33 9,713 5
J1240 Dimenhydrinate injection $0.02 8,738 12
J1000 Depo-estradiol cypionate inj $11.84 1,738 11
J1230 Methadone injection $4.00 1,439 2
J1212 Dimethyl sulfoxide 50% 50 ml $175.32 1,145 5
J1265 Dopamine injection $2.67 840 1
J0132 Acetylcysteine injection $0.11 814 6
J0834 Inj., cosyntropin, 0.25 mg $60.82 696 6
J1120 Acetazolamid sodium injectio $8.30 446 4
J0713 Inj ceftazidime per 500 mg $8.01 398 5
J0698 Cefotaxime sodium injection $0.61 371 9
J0775 Collagenase, clost hist inj $9,463 323 1
J0207 Amifostine $23.74 42 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.